This article briefly describes the imaging performance standards of the kilovolt X-ray image guidance system used in radiotherapy, analyzes the main aspects that should be considered in the image quality of X-IGRT system, and focuses on parameters that should be considered in the imaging performance evaluation criteria of the CBCT X-IGRT. The purpose is to sort out the imaging performance evaluation standards of kilovolt X-IGRT system, clarify the image quality requirements of X-IGRT equipment, and reach a consensus when evaluating the imaging performance of X-IGRT system.
Radiotherapy Planning, Computer-Assisted/methods* ; Cone-Beam Computed Tomography/methods* ; Spiral Cone-Beam Computed Tomography ; Radiotherapy, Intensity-Modulated/methods* ; Radiotherapy, Image-Guided/methods*

Objective:To develop the real-time radiotherapy monitoring system of three-dimensional (3D) point cloud by using depth camera and verify its feasibility.Methods:Taking the depth camera coordinate system as the world coordinate system, the conversion relationship between the simulation CT coordinate system and the world coordinate system was obtained from the calibration module. The patient's simulation CT point cloud was transformed into the world coordinate system through the above relationship, and registered with the patient's surface point cloud obtained in real-time manner by the depth camera to calculate the six-dimensional (6D) error, and complete the positioning verification and fractional internal position error monitoring in radiotherapy. Mean and standard deviation of 6D calculation error, Hausdorff distance of point cloud after registration and the running time of each part of the program were calculated to verify the feasibility of the system. Fifteen real patients were selected to calculate the 6D error between the system and cone beam CT (CBCT).Results:In the phantom experiment, the errors of the system in the x, y and z axes were (1.292±0.880)mm, (1.963±1.115)mm, (1.496±1.045)mm, respectively, and the errors in the rotation, pitch and roll directions were 0.201°±0.181°, 0.286°±0.326°, 0.181°±0.192°, respectively. For real patients, the translational error of the system was within 2.6 mm, the rotational error was approximately 1°, and the program run at 1-2 frames/s. The precision and speed met the radiotherapy requirement. Conclusion:The 3D point cloud radiotherapy real-time monitoring system based on depth camera can automatically complete the positioning verification before radiotherapy, real-time monitoring of body position during radiotherapy, and provide error visual feedback, which has potential clinical application value.

ObjectiveTo explore the status and influencing factors of electric bicycle （e-bike）-related traffic injury in Songjiang District of Shanghai， and to provide reference for prevention and control of the injury. MethodsA self-designed questionnaire was used to investigate the community residents over 16 years old who rode e-bike in Songjiang Western Industrial Zone. The survey included general demographic characteristics， physical and psychological conditions， e-bike use， accidents and injuries. Descriptive analysis， chi-square test and Fisher's exact probability method were used to explore the influencing factors of traffic injury by e-bike in Songjiang District. Results1 030 questionnaires were distributed and 1 013 valid questionnaires were recovered. The effective rate of the questionnaire was 98.35%. From June 2020 to May 2021， the incidence of e-bike traffic accidents in Songjiang Western Industrial Zone was 17.47% and the incidence of injuries was 12.64%. The difference between e-bike accident group and non accident group was statistically significant （P<0.05） in the following factors： gender， registered residence， educational level， sleeping time， fatigue， violation of traffic regulations including speed limit 25 km‧h^-1 and crossing of red traffic lights， riding after alcohol drinking， riding speed higher than 30 km‧h^-1， riding on the phone， wearing headset， turning without prompting signal， riding on the lane of motor vehicles，and e-bike life. The top three injured body parts were limb pelvis （48.10%）， body surface （27.85%） and head （13.92%）. The nature of injury was mainly contusion / abrasion （82.03%）， followed by fracture （17.19%）. ConclusionThe incidence of e-bike traffic accidents in Songjiang District is high. We should strengthen the traffic safety education of e-bike riders， strengthen the road traffic control， and reduce the occurrence of e-bike road traffic accidents in Songjiang District.

Objective:To develop a 3D visualization technology-assisted patient positioning system for radiotherapy and compare it with traditional patient positioning method for breast and pelvic radiotherapy.Methods:A total of 40 patients receiving radiotherapy in Changzhou No.2 People′s Hospital from June 2020 to April 2021 were selected for this study, including 20 patients with breast cancer and 20 patients with pelvic cancer.3D visualization reconstruction was carried out using the CT data of the patients for positioning. Then the 3D visualization models were integrated with the real treatment environment and were then shifted to the isocentral positions of accelerators through interactive operations. Based on this, the patients were actually positioned. Every week, all of the patients were firstly treated with traditional positioning, followed by 3D visualization-guided positioning. As a result, 240 times of positioning data of all patients were collected in three weeks. They were compared with the data of cone-beam CT(CBCT)-guided positioning, which served as the gold standard.Results:The absolute positioning errors of 3D visualization-guided positioning along x, y and z axes were (1.92±1.23), (2.04±1.16), and (1.77±1.37)mm, respectively for patients with breast cancer and were (2.07±1.08), (1.33±0.88), and (1.99±1.25)mm, respectively for patients with pelvic cancer. Compared with traditional positioning method , the accuracy of 3D visualization-guided positioning along x、 y, and z axes was increased by 38.83%, 52.40% and 33%, respectively for patients with breast cancer and was improved by 36.84%, 54.04% and 52.58% for patients with pelvic cancer, with all differences being statistically significant along y and z axes ( t=2.956-5.734, P< 0.05). Meanwhile, the error distribution of the two positioning method was statistically significant along in y axis for patients with breast cancer( χ2=7.481, P<0.05) and was statistically significant along each axis for patients with pelvic cancer( χ2=5.900, 6.415, 7.200, P<0.05). Conclusions:The positioning method guided by 3D visualization technology can effectively improve the positioning accuracy of patients with breast cancer and patients with pelvic cancer and is of value in potential clinical application.

Objective:To explore the volume resolution of prostate motion target by four-dimensional (4D) ultrasound.Methods:The prostate ultrasound model was selected, and the group comparison study was conducted using 4D ultrasound to outline the prostate target under different motion amplitudes (A) and motion period (T). The simulated A value was set as 0.5 mm, 1 mm, 2 mm, 3 mm, 4 mm, and 5 mm, respectively. The T value was set as 1 s, 2 s, 3 s, and 4 s, respectively. The volume of the target of the model prostate was calculated, and the static ultrasound image of the target was used as the control group to analyze the difference between two groups.Results:When the model was still, the size of the target of ultrasound was consistent with that of CT scan ( P>0.05). When the A values were 0.5 mm and 1 mm, there was no statistical difference between the volume in period 1-4 s and the volume in the target at rest (all P>0.05). When the A values were 2 mm and 3 mm, and the T values were 1 s, 2 s and 3 s there was statistical difference between the volume of target and that of of static ultrasonic target (all P<0.05). When the A value was 2 mm and the T value was 4 s, there was no statistical difference between the target volume and the static target volume ( P=0.710). The range within the group was 6.7 cm 3, and the standard deviation was 1.15 cm 3. When the A value was 3 mm and the T value was 4 s, the volume repeatability of the target was poor, and the range within the group was 14.4 cm 3; when the A values were 4 mm and 5 mm, and the T values were 1-4 s, the range within the group was 3.27-17.63 cm 3 and 6.51-21.02 cm 3, respectively. The volume repeatability of the target under each period was extremely poor, which could not meet the clinical requirements. Conclusion:4D ultrasound can provide reliable reference data for patients′ target delineation within 1-4 s of motion cycle and within 1 mm of motion amplitude, which exerts on effect upon the original position of probe.

Objective To investigate the cognition and attitude toward integrating old-age care with medical services among the elderly,nurses from medical institutions and old-age care institution staffs,in order to provide references for developing implementation strategies of integrating old-age care with medical service.Methods The convenience sampling method was conducted,and 963 people.from 4 cities in Henan Province were enrolled in this survey from July to September 2016,including 599 elderly people,248 nurses from medical institutions and 166 old-age care institution staffs.All volunteers were investigated by using self-designed questionnaires.Results A total of 1 000 questionnaires were distributed,and 963 valid questionnaires were retrieved.The effective recovery rate was 96.3％.The cognition of integrating old-age care with medical service in all volunteers was low.There were differences in the needs of all nursing care services in the integrative old-age care and medical services,the needs of Chinese traditional medical care services were low.The highest demand of service capabilities was skills of coping urgent issues,while the lowest demand of service capabilities was education levels of care givers;the scores on evaluation of the two demands in the elderly were (4.803± 0.453) and (3.124± 1.246) points,those in the old-age care institution staffs were (4.819±0.468) and (2.698± 1.346) points,there was no statistically significant difference between the two groups (P＞0.05).Conclusion In the progress of promoting the integration of old-age care and medical services,it is necessary pay more attention on the promotion among non-urban elderly people,and improving living facilities as well as the quality of care services.Integrated management and hierarchical training for nursing professionals and old-age care institutions staffs should be carried out gradually.

Objective To investigate value of peripheral NLR and PLR for the survival of patients with neuroblastoma.Methods The clinical data of 41 neuroblastoma patients were analyzed by the Kaplan-Meier,Log-rank test,and multivariate COX regression.Results NLR,PLR levels of neuroblastoma patients were significantly higher than that in the healthy control group (1.81 ±0.29 vs.1.07 ±0.29,P ＜ 0.01) (169 ± 23 vs.76 ± 3,P ＜ 0.01);The elder the age,the higher the clinical stages,the higher the serum levels of NSE,and urine VMA were,the higher was the NLR (x2 =3.93,6.286,7.676,6.689,all P＜0.05) and PLR (x2 =4.111,5.707,8.019,8.922,all P ＜0.05).The higher the serum level of LDH,the higher was the NLR (x2 =7.769,P =0.02).3-year overall survival in low NLR group was 84％ and that in high NLR group was 73％ (x2 =4.002,P =0.045);3-year progression-free survival in low NLR group was 74％ and that in high NLR group was 50％ (x2 =4.082,P =0.043);3-year progression-free survival of low PLR group was 85％ and high PLR group was 38％ (x2 =9.388,P =0.002).The clinical stages,MYCN genetic expression,NLR levels were independent factors for the overall survial in patients with neuroblastoma (P ＜ 0.05).Conclusion Pretreatment NLR level can effectively predict the prognosis of neuroblastoma.

A method of direct injection and liquid chromatography coupled with tandem mass spectrometric (LC-MS / MS) was developed for simultaneous determination of 5 aniline compounds including aniline, 3-nitroaniline, 4-nitroaniline, 2,6-dichloro-4-nitroaniline and hexanitrodiphenylamine in drinking water and source water. The samples were filtered using a 0. 22-μm polyethersulfone membrane prior to HPLC analysis. Five target compounds were chromatographically separated on an HSS T3 column with gradient elution. Chromatographic data were acquired by tandem mass spectrometric detection in multiple reaction monitoring (MRM) mode, and thus favorable resolutions of all target compounds were achieved within 4 min. Under the optimal analytical conditions, the peak area of each analyte and its concentration had a good correlation within the linear range (R≥0. 995). The limit of detection (LOD) and limit of quantification (LOQ) of the method were 0. 773-1. 88 μg / L (S / N=3) and 2. 58-6. 27 μg / L (S / N=10), respectively. The intra- and inter-day relative standard deviations ( RSDs) of the mix standard solution were 0. 8% -1. 9% and 3. 3% -4. 9% , respectively. The spiked recoveries of the analytes were 84. 1% -105% and the RSDs of the spiked samples were 1. 0% -3. 1% . This proposed method was applied in the analysis of 35 samples from drinking water, source water and surface water, which indicated that the novel LC-MS / MS method could detect 5 aniline compounds in water without any complicated sample pretreatment in an accurate, sensitive and rapid way, and it also could provide technique support for evaluation of the contamination caused by aniline compounds.

This study was aimed to observe the safety and effectiveness ofShugan Jieyu Capsules in the treatment of vasovagal syncope (VVS) with mild-to-moderate depression and anxiety, and to compare the effect with Flupentixol and Melitracen Tablets. A total of 89 VVS cases with mild-to-moderate depression and anxiety were randomly divided into 3 groups, which were group A (Shugan Jieyu Capsules group), group B (Flupentixol and Melitracen Tablets) and group C (control group). Based on the conventional therapy of VVS treatment, treatments were given to all three groups for 8 weeks. And the negative conversion ratio of VVS in each group was observed. Hamilton Depression Scale (HAMD 24 items) and Hamilton Anxiety Scale (HAMA) were evaluated for the calculation of reductive rate. Treatment emergent symptoms scale (TESS) was used in the evaluation of adverse reactions of both medications during the treatment. In the 12-month follow-up after treatment, the recurrence rate of syncope was observed in each group. The results showed that compared with pretreatment, HAMD-24 and HAMA scores of group A and group B after treatment were significantly reduced (P < 0.05). Compared with group C, the heat-up tilt testing-negative rate, HAMD-24 and HAMA reductive rate of group A and group B after treatment were significantly increased (P < 0.05). Compared with group B, the negative rate, HAMD-24 and HAMA reductive rate of group A were more significant (P < 0.05). After treatment, scores for TESS of group A was significantly lower than group B (P< 0.05). In the 24-month follow-up, the recurrence rate of syncope of group A and group B was significantly lower than group C (P < 0.05); and group A was obviously better than group B (P < 0.05). It was concluded thatShugan Jieyu Capsules can be used in the treatment of VVS with mild-to-moderate depression and anxiety. Its effectiveness and safety may be better than Flupentixol and Melitracen Tablets.

This study was aimed to investigate the effect ofDanlou pills on prevent atherosclerosis from hypercholesterolemia rabbit and its relationship with inflammatory factors as well as PI3K/AKT signal pathways. A total of 24 Japanese male white rabbits were randomly divided into the control group (CL), model group (M) and Danlou group (DL), with 8 in each group. Normal diet was given to CL rabbits. High-fat diet was given to rabbits in other groups to establish the atherosclerosis model. Danlou pills (0.5 g·kg-1·d-1) were also given to DL rabbits. Rabbits were sacrificed after 9-week medication. The contents of blood lipid, TNF-α and IL-6 were detected. HE staining was used in the observation of histological changes in the aorta. Western blot was used to observe PI3K and p-AKT expression in the aorta. The results showed that compared with CL, the contents of TG, TC, LDL, IL-6 and TNF-α were significantly increased in M (P < 0.01); PI3K and p-AKT expression in the aorta were significantly decreased (P < 0.01). Compared with M, blood lipid, IL-6 and TNF-α were significantly reduced in DL (P < 0.05, orP < 0.01); PI3K and p-AKT expression were significantly increased (P < 0.01). It was concluded thatDanlou pills had prevention effects on atherosclerosis through reducing blood lipid and inflammatory factors. The action mechanism maybe related to the activation of PI3K/AKT signal pathways.